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ĐẠI HỌC QUỐC GIA HÀ NỘI TRƯỜNG QUẢN TRỊ VÀ KINH DOANH - VƯƠNG MỸ LIÊN AUTONOMY MECHANISM AT QUANG NINH PROVINCIAL DEPARTMENT OF HEALTH CARE AND PROTECTION CƠ CHẾ TỰ CHỦ TÀI CHÍNH TẠI BAN BẢO VỆ CHĂM SĨC SỨC KHỎE CÁN BỘ TỈNH QUẢNG NINH Chuyên ngành: Quản trị kinh doanh Mã số: 8340101.01 TÓM TẮT LUẬN VĂN THẠC SĨ QUẢN TRỊ KINH DOANH NGƯỜI HƯỚNG DẪN KHOA HỌC: PGS.TS PHẠM THỊ THANH HOÀ HÀ NỘI - 2023 PREAMBLE The urgency of the topic The implementation of the autonomy mechanism for the Department has positively impacted the quality of operation, such as improving service quality; Proactively in the policy of remuneration, attracting health workers, highly skilled doctors, Thereby, improving the quality of examination, health care and professional duties However, at present, there are also some limitations, shortcomings and impacts when implementing this policy, so the implementation of the topic: “ Autonomy Mechanism at Quang Ninh provincial Department of Health Care and Protection ”is necessary in the current period Research situation related to the thesis topic In recent times, there have been many research topics on the implementation of the autonomy mechanism of public non -business units, Research objectives Studying the implementation of financial autonomy mechanism at the Quang Ninh provincial Department of Health Care and Protection in the period of 2017 - 2021 to propose some solutions to perfect the financial autonomy mechanism at the Quang Ninh provincial Department of Health Care and Protection Subjects of research The subject of the thesis is the Autonomy Mechanism at Quang Ninh provincial Department of Health Care and Protection’’ Scope of research About space: The thesis researches the Autonomy Mechanism at Quang Ninh provincial Department of Health Care and Protection Regarding time: Research thesis, analysis and assessment of the status of autonomy at the Quang Ninh provincial Department of Health Care and Protection in the period of 20172021 and propose solutions for the following years Research method The thesis uses dialectical materialism, historical materialism and specific research methods such as statistics, comparison, synthesis, systematization, modeling - Methodology - Mathematical statistical method -Technical methods Literature structure In addition to the beginning, conclusion, list of reference documents, the content of the thesis constitutes chapters: Chapter 1: General theoretical issues on financial autonomy for public non -business units Chapter 2: Research method Chapter 3: Actual situation of the implementation of financial autonomy at the Quang Ninh provincial Department of Health Care and Protection Chapter 4: Solutions to improve the financial autonomy mechanism at the Quang Ninh provincial Department of Health Care and Protection in the coming time Chapter General theory of financial autonomy for public non -business units in the field of health 1.1 Public non -business units in the field of health 1.1.1 Concept, characteristics, classification of public non -business units in the field of health ĐVSNCL in the field of health exercise, self -responsibility must be an independent estimate unit, with separate seals and accounts, organizational structure The fields of health care, social security and contribute to promoting the country's economic growth However, public activities (HDSN) in the health sector have distinctive features compared to other economic activities in the economy * Based on non -business revenue (fee collection, fee, service collection, other revenues ) ĐVSNCL in the field of health classified to exercise autonomy and self responsibility as follows: Health non -business units are registered and classified according to the following groups: a) Group 1: The unit has a non -business revenue to ensure all regular operating funds and development investment funds; b) Group 2: The unit has a non -business revenue to ensure all operating funds regularly; c) Group 3: The unit has a non -business revenue to ensure a part of regular operating funds; d) Group 4: The unit has a low non -business revenue or has no revenue and funding for regular operations according to the functions and tasks assigned by the State budget to ensure the whole From this classification, it can be seen that the phrase "financial autonomy" is considered one of the important criteria for classification of ĐVSNCL 1.1.2 The role of public non -business units in the field of health Because of the role of health for such great people and society, our Party and State always pay special attention to the development of health careers and increase investment in resources for this career Although there are still issues that need to continue to overcome, under the leadership and management of the State's health careers in our country in the past have achieved great achievements, greatly contributing to The great achievements of our country in the war to protect the country as well as in the construction of the country 1.2 Financial autonomy for public non -business units in the field of health 1.2.1 The concept of financial autonomy mechanism In Vietnam today, the Financial Autonomy mechanism is implemented in accordance with the Government's Decree No 43/2006/ND-CP of April 25, 2006 (hereinafter referred to as Decree 43), regulations on The right to autonomy and self-responsibility for the performance of tasks, organizational structure, payroll and finance for the CLCs and Decree No 60/2021/ND-CP dated June 21, 2021 Financial owner of public non -business unit In which, ĐVSNCL is given autonomy and self -responsibility in creating and using financial resources to perform tasks in their field of activity 1.2.2 Financial autonomy characteristics of public health care units The financial autonomy of public health non -business unit is the key to determining the success or failure of the unit management, the lag or development of the unit Financial autonomy activities of public health non -business units have the following characteristics: Selling subsidy finance: Finance for sale: Finance focused on operating: Finance does not accumulate: Finance does not have an effective price index: 1.2.3 Financial autonomy classification of public health care units Under the provisions of Article 26 of Decree 60/2021/ND-CP on the financial autonomy mechanism of public non-business units stipulating the classification of financial autonomy of public non-business units as follows as follows : * Group unit: Public non -business units ensure recurrent spending and investment spending (hereinafter referred to as unit unit) * Group unit: Public non -business units ensure recurrent expenditures (hereinafter referred to as group unit) * Group unit: Public non -business unit self -guarantee a part of recurrent expenditure (hereinafter referred to as group unit) * Group unit: Public non -business units guaranteed by the State (hereinafter referred to as group unit) 1.2.4 The financial autonomy content of the public health career unit 1.2.4.1 Financial sources of public non -business units in the field of health On June 21, 2021 stipulates the financial source of the unit including the following sources: * Career operation revenue a) Revenue from public non -business service activities; b) Revenue from production and business activities; joint venture activities, associated with organizations and individuals in accordance with the law and approved by the competent authority in accordance with the functions and tasks of the public non -business unit; c) Revenue from public property leasing: The unit fully implements the provisions of the law on the management and use of public property and must be approved by the competent agency for leasing public property * The remaining fee for public non -business units to spend in accordance with the law on charges and fees *Loan source; Source of aid and funding in accordance with the law * Other revenues as prescribed by law (if any) 1.2.4.2 Expenses of public non -business units in the field of health * Expenses for autonomy Payment of salary and payable amounts according to wages; Expenses for hiring experts, scientists, people with special talent to perform the tasks of agencies, organizations and units; Expenses for professional activities, management expenditures ; Expenses for performing jobs and charges in accordance with the law and charges; Expenses for service activities Setting up provisions as prescribed for enterprises, except for cases where specialized laws are stipulated to set up specific funds to handle risks (if any) Payment of loan interest in accordance with the law (if any) Other expenditures as prescribed by law (if any) * Regular spending is not given autonomy and performing scientific and technological tasks Regular spending without autonomy includes: a) Expenses for performing the tasks assigned by the State at Point c, Clause 1, Article 11 of this Decree in accordance with the law on the state budget and the law for each funding source; b) Expenses for procurement of assets, large repair for toll collection from the fee source left (the part is left to buy and repair large assets, machinery and equipment for charges ); c) Expenses from borrowed sources, aid and funding according to the provisions of law Expenses for performing scientific and technological Public non -business units must strictly comply with the State's regulations on foreign -working regimes, foreign guests and international conferences in Vietnam 1.2.4.3 The mechanism of autonomy on collection management of public non business units in the field of health All types of ĐVSN are assigned by competent state agencies to collect and collect fees properly and collect sufficiently according to the revenue and collection subjects prescr ibed by competent state agencies In case the competent state agency shall stipulate the collection frame, the unit shall base on the expenditure needs for activities and the ability to contribute to society to determine the specific collection level to suit each type of activity , each object but must not exceed the collection frame prescribed by the competent authority The unit implements the regime of exemption and reduction for social policy beneficiaries according to the State's regulations 1.2.4.4 The mechanism of autonomy in distribution and use of financial resources of public non -business units in the field of health For units to ensure operating costs and the unit self -guarantee a part of operating costs: Based on the assigned tasks and financial resources, for recurrent expenditures, the head of the unit shall be decided by a number of management spending, higher or lower operating expenditures than the agency by the agency The state is competent In particular, the ĐVSNCL in the field of health is mostly belonging to these units For units by the state budget to ensure all operating expenses, the head of the unit shall be decided by some levels of management and operational expenditures, but maximum is not too much for the competent state agency regulations Based on the nature of the work, the head of all ĐVSNCL is determined the method of contracting costs for each department and unit Decision on construction investment, new procurement and large repair of assets comply with the law Some cost norms must be guaranteed by the state norms, not exceeding that norm * For salary, labor costs *For additional income 11.2.4.5 Profit distribution of state health units - For units to ensure operating costs + Minimum deduction of 25% to set up the HDSD Development Fund; + Paying additional income for workers, the State does not control the maximum level; + Set up reward funds, welfare funds, income stabilization reserve funds For two reward and welfare funds, the maximum deduction level shall not exceed months of wages, wages and income increased on average in the year The additional income payment level, setting up funds decided by the Head of the CPV of the unit according to the unit's internal spending regulations - For ĐVSNCL guarantee a part of the revenue source + Minimum deduction of 25% to set up the HDSD Development Fund + Payment of additional income in the year but not more than times the salary fund, positions in the year prescribed by the State + Set up reward funds, welfare funds, income stabilization reserve funds For two reward and welfare funds, the maximum deduction level shall not exceed months of wages, wages and income increased on average in the year + Minimum deduction of 25% to set up the HDSD Development Fund + Payment of additional income in the year but not more than times the salary fund, positions in the year prescribed by the State + Set up reward funds, welfare funds, income stabilization reserve funds For two reward and welfare funds, the maximum deduction level shall not exceed months of wages, wages and income increased on average in the year * The use of funds in non -business units is prescribed as follows + The Development Fund is used to invest in developing, improving the quality of the Council, + The reserve fund stabilizes income to ensure income for workers + The reward fund is used for periodic and unexpected rewards for collectives and individuals inside and outside the unit according to the work efficiency and achievements contributing to the operation of the unit + The welfare fund is used to build and repair welfare works, spend on collective welfare activities of workers in the unit, unexpected difficulties for workers, including vacation retirement, losing effort, extra spending for employees in the payroll to streamline the payroll, the head of the unit decides the use of the fund according to the unit's internal spending regulations 1.2.4.6 Manage and use capital and assets of public non -business units in the field of health ĐVSN is responsible for managing and using effective assets in accordance with the current regulations of the State and the guidance of the Ministry of Health on the financial regime applicable to the ĐVSN 1.2.5 The role of financial autonomy for state health units The management and use of financial resources in public hospitals directly related to socio economic efficiency and the people's contributions Therefore, if the finance of public hospitals is managed, supervised and inspected well, it would contribute to limiting and preventing negative phenomena and corruption in exploiting and using public financial resources , at the same time improving the efficiency of the country's financial sources 1.3 Factors affecting the financial autonomy for state health units 1.3.1 Guidelines and policies of the Party and the State Health non -business units established by the State to carry out the management and provision of public services or professional tasks in the field of health care Therefore, the mechanism of operation of state health units in general and the financial management mechanism of the state health unit in particular is greatly affected by the State's policies 1.3.2 Financial management mechanism Financial management mechanism of ĐVSNCL contributes to creating a legal corridor for the process of creating and using financial resources It is built in a unified and appropriate viewpoint, from the formulation of the norms, spending norms to the regulations on allocation, inspection, control, that process to promote a few tricks of the mechanism financial autonomy 1.3.3 Structure and capacity of cadres and employees in the State unit Humans are the central factor of the management apparatus, which is important in processing information to set management decisions 1.3.4 The inspection and control of the financial situation of the non -business unit In the process of implementing the financial activities of the unit such as the organization of revenue and expenditure management, the establishment of a financial inspection and control system is a very important content Chapter Research method 2.1 Research question To solve the goals and meet the research content of the thesis, it is necessary to answer the following questions: What is the current situation of financial autonomy at the Quang Ninh provincial Department of Health Care and Protection? Factors affecting the financial autonomy mechanism at the provincial cadres health care department? What solutions to be implemented to improve the financial autonomy mechanism at the provincial cadres health care department? 2.2 Research Methods 2.2.1 Methodical basis The methodology basis used in the thesis is dialectical materialism Dialectical materialism is used to study the phenomenon, scientific and objective mobilization status of the research subjects 2.2.2 The method of selecting research points a Select the research location: The author chooses the study area as the Quang Ninh provincial Department of Health Care and Protection because here has gathered all conditions for implementing Decree 16/2015/ND-CP "on autonomy and self-esteem take responsibility for performing tasks, organizational structure, payroll and finance for public non -business units ” b Subject matter investigated: Investigating and interviewing the unit leaders such as Deputy Head ; Director of Nursing House, Chief of Office; Deputy Chief of Office; Head of Health Management and Chief Nursing Clinic + Interview content: The contents related to the financial autonomy of the Quang Ninh provincial Department of Health Care and Protection Assigned task plan; Results of performing assigned tasks, non -business collection activities; The implementation of internal spending regulations at the unit; Advantages and difficulties when implementing autonomy mechanism in financial management; Labor income situation; Quality of patient service; Proposals, recommendations 10 + Time and form of interview: At the office of the subjects interviewed in the period of 57/2022 2.2.3 The method of data collection - Analysis method - Statistical methods - Comparative method - Integrated approach 2.3 System of research criteria 2.3.1 The indicators reflect the operation situation of the unit - The number of patients with medical examination and treatment (outpatient) through each year - The average number of days of treatment 2.3.2 Indicators to evaluate financial autonomy at the unit 11 Chapter Actual situation of financial autonomy at the Quang Ninh provincial Department of Health Care and Protection 3.1 Overview of the Quang Ninh provincial Department of Health Care and Protection 3.1.1 About the Quang Ninh provincial Department of Health Care and Protection 3.1.1.1 Development formation process 3.1.1.2 Functions, tasks and organizational structure of the Quang Ninh provincial Department of Health Care and Protection 3.1.1.3 Organizational structure of the Quang Ninh provincial Department of Health Care and Protection The unit includes 03 parts: Clinic-QLSK, Nursing Guest House and Office 3.1.1.4 Human Resources The personnel currently available at the unit is 30 people, including - Leadership: 01 person; - Office department: 06 people; - Clinic: 15 people; - Nursing motel: people Human resources of the Quang Ninh provincial Department of Health Care and Protection in the period of 2017 - 2021 are relatively stable 3.1.2 The situation of performing professional work at Ban Table 3.2 Results of some main activities of Quang Ninh Provincial Department of Health Care and Protection in the period of 2017 - 2021 Targets Unit 2017 2018 2019 2020 2021 Regular health care People 4.247 4.351 4.502 4.625 4.752 Periodic health check People 2.654 2.663 2.796 2.899 2.984 Rehabilitation nursing People 1.108 1.135 1.200 1.218 1.309 Health Management People 2.786 2.864 2.925 2.938 2.968 Source: Quang Ninh Provincial Department of Health Care and Protection 12 Chart 3.2 Results of some main activities of Quang Ninh Provincial Department of Health Care and Protection in the period of 2017 – 2021 Regular medical examination and treatment Periodic health check-ups Every year, the Quang Ninh Provincial Department of Health Care and Protection, based on the plan of periodical health examination for officials of the Central Committee for Health Care and Protection, Rehabilitation nursing work On average, every year, about 1,200 people are welcome to stay at the nursing home Staff health management Along with regular medical examination and treatment, periodical medical examination for leaders, the management of leaders; health records is also updated continuously and timely 3.2 Actual situation of financial autonomy mechanism at Quang Ninh Provincial Department of Health Care and Protection 3.2.1 Actual situation of self-collection at Quang Ninh Provincial Department of Health Care and Protection The Quang Ninh Provincial Department of Health Care and Protection maintains medical examination and treatment activities mainly from 02 main sources of revenue: the state budget and revenues from other non-business revenues: Table 3.3 Summary of revenue sources of Quang Ninh Provincial Department of Health Care and Protection for the period 2017 – 2021 Unit: million VND Targets In 2017 TH % In 2018 TH % In 2019 TH % In 2020 TH In 2021 % TH State budget grant 21,703 79.0 97,308 94.9 28,632 71.7 28,555 75.9 25,223 Self-funding 6,143 22.3 6,516 6.4 6,451 16.2 6,783 18.0 5,294 Funding is not self-executing 15,560 56.6 90,792 88.5 22,181 55.6 21,772 57.9 19,929 Other non- 5,783 21.0 5,228 5.1 11,293 28.3 9,057 24.1 7,399 13 % 7 business income: income from nursing activities in neighboring provinces, collection of medical services Tổng số 27,486 100 102,53 100 39,925 100 37,612 100 32,622 Source: Quang Ninh Provincial Department of Health Care and Protection 120,000 300.00 102,536 250.00 100,000 200.00 80,000 150.00 60,000 40,000 100.00 39,925 37,612 27,486 32,622 50.00 0.00 20,000 -50.00 -100.00 Năm 2017 Năm 2018 Năm 2019 Năm 2020 Tổng nguồn thu (triệu đồng) Năm 2021 Tốc độ tăng trưởng (%) Chart 3.3 Summary of revenue sources of Quang Ninh Provincial Department of Health Care and Protection in the period of 2017 – 2021 Box PV1: Interview results on revenue management mechanis Table 3.4 Summary of expenditures of Quang Ninh Provincial Department of Health Care and Protection in the period of 2017 - 2021 Targets Recurring expenses Individual payment group Professional expenditure group Other genera Irregular expenses Group spending on purchasing and repairing fixed assets Other genera total expenditure In 2017 TH % In 2018 TH % In 2019 TH % Năm 2020 TH % Năm 2021 TH % 11,925 43.39 11,743 11.45 17,888 44.8 15,840 42.11 12,693 38.91 4,050 14.73 4,545 4.43 5,997 15.02 5,921 15.74 4,669 14.31 6,491 23.62 3,670 3.58 4,607 11.54 3,860 10.26 3,099 9.50 1,384 5.035 3,528 3.44 7,284 18.24 6,059 16.11 4,925 15.10 15,561 56.61 90,793 88.55 22,037 55.2 21,772 57.89 19,929 61.09 5,691 20.71 50,031 48.79 1,056 2.645 2,822 7.50 829 2.54 9,870 27,486 35.91 100 40,762 102,53 39.75 100 20,981 39,925 52.55 100 18,950 37,612 50.38 100 19,100 32,622 58.55 100 14 0 Source: Quang Ninh Provincial Department of Health Care and Protection 120,000 102,536 90,793 100,000 80,000 60,000 39,925 40,000 27,486 15,561 11,925 20,000 37,612 22,037 17,888 11,743 21,772 15,840 32,622 19,929 12,693 Năm 2017 Năm 2018 Chi thường xuyên Năm 2019 Năm 2020 Năm 2021 Tổng chi Chi không thường xuyên 3.2.2 Exercising autonomy in spending according to the internal spending regulations of the Quang Ninh Provincial Department of Health Care and Protection 3.2.3 Implement financial inspection and control mechanism at Quang Ninh Provincial Department of Health Care and Protection 3.2.3.1 Check and control the revenue Table 3.3 Results of the inspection and control of revenues at the Quang Ninh Provincial Department of Health Care and Protection In 2017 In 2018 In 2019 In 2020 In 2021 Targets Unit Number of violations Times Million dong Amount of violation 1 0 80 89 - - - Ratio of violation % 0,29 0,09 amount to total revenue Source: Quang Ninh Provincial Department of Health Care and Protection 3.2.3.2 Check and control expenses The results of the inspection and control of expenditures at the Quang Ninh Provincial Department of Health Care and Protection in the period 2017-2021 are reflected in the following table: Table 3.4 Results of the inspection and control of expenditures at the Quang Ninh Provincial Department of Health Care and Protection for the period 2017 -2021 Targets Number violations of Unit In 2017 Times In 2018 15 In 2019 In 2020 In 2021 0 Amount of violation Millio n dong 193 37 - - - Ratio of violation amount to Total % 0,7 0,04 spending source Source: Quang Ninh Provincial Department of Health Care and Protection Box of PV4: Interview results about the organization of inspection and approval 3.2.4 Budgeting, budget execution, accounting and settlement of revenues and expenditures Quang Ninh Provincial Department of Health Care and Protection The annual expenditure estimate developed by the Accounting Department of the Board in collaboration with functional departments includes the following contents: a Estimating b Estimation implementation c Financial settlement * The situation of autonomy in management and use of funds The results of setting up and using funds for the period 2017 - 2021 are as follows: Table 3.5 Setting up funds of the Quang Ninh Provincial Department of Health Care and Protection for the period 2017 - 2021 In 2017 In 2018 In 2019 In 2020 1.572 1.447 2.761 2.141 2.750 317 166 545 398 350 Income Supplement Fund 975 824 1.712 1.175 1.548 Bonus and welfare Fund 280 457 503 568 852 Targets Unit Profit Foundation for career development Source: Quang Ninh Provincial Department of Health Care and Protection * Mechanism of asset and material management *Evaluation of efficiency and effectiveness Box PV5: Interview results on the organization of financial statements and disclosure of financial statements Box PV6: Interview results on accounting, accounting and settlement situation 3.3 Assessing the status of financial autonomy implementation of Quang Ninh Provincial Department of Health Care and Protection in the period of 2017 – 2021 16 3.3.1 These achievements 3.3.2 Shortcomings and causes * Difficulties and shortcomings Developing a financial plan at the Board is an annual plan, not yet detailed long term plans, monthly and quarterly plans Operating expenses are increasing at a rapid rate * Reason + Subjective causes + Objective reasons 17 CHAPTER SOLUTIONS TO FINISHING THE FINANCIAL AUTHORITY IN THE COMMITTEE OF THE HEALTH CARE PROTECTION OF QUANG NINH PROVINCE IN THE NEXT TIME 4.1 Objectives and development orientation of the Health Protection and Care Board of Quang Ninh province in the coming time 18 4.1.1 Target 4.1.2 Key missions Political and ideological work Professional and technical work 4.2 Viewpoints and orientations on financial autonomy in public health service units in general and Quang Ninh Provincial Health Care Protection Committee in particular Policy on autonomy in financial management at health care institutions Public health facilities Financial autonomy perspective Coupled with the planning of the network of medical examination, treatment and rehabilitation, is the renewal of the operating mechanism, financial mechanism, salary policy and medical service price in hospitals public health service unit * Orientation to improve the financial autonomy mechanism Currently, Quang Ninh Provincial People's Committee is encouraging units with large incomes to switch from the group of units that self-finance a part of their regular operating expenses to the group of self-financed units 4.3 Solutions to improve financial autonomy at the Quang Ninh Provincial Department of Health Care and Protection in the coming time 4.3.1 Raising awareness about financial autonomy * Capacity building of cadres and civil servants 4.3.2 Diversifying revenue sources for the Quang Ninh Provincial Department of Health Care Protection 4.3.3 Strengthening management to improve the efficiency of expenditures 4.3.4 Improve the mechanism of salary payment and income distribution 4.3.5 Strengthening the management of public assets 4.4 Solutions on financial inspection and supervision Strengthening control of state budget spending through the state treasury system Basic solution to complete the accounting and internal audit inspection system: Management innovation is associated with increased accountability in the Department 19 4.5 Conditions for implementing the solution 4.5.1 For state management agencies 4.5.2 For the Quang Ninh Provincial Department of Health Care and Protection In order to well implement the above solutions for the Quang Ninh Provincial Department of Health Care and Protection Improving the management apparatus and organization in the unit Building an independent internal control system Develop treatment guidelines and strengthen the role of Professional Councils At the Health Care Protection Board of Quang Ninh officials, Decree 43 has created a wide legal corridor for the Health Care Protection Board of Quang Ninh officials to maximize their autonomy and self-responsibility to increase revenue, save costs, reinvest, accumulate, develop the Board and improve the lives of employees at the unit after a period of implementation at the Department of Health Care and Protection of Quang Ninh officials has shown This is a correct policy of the Party and State for the care and protection of people's health On the basis of applying theory and research In the past time, the topic has focused on solving the following basic problems: Clarifying the theoretical issues about the financial management mechanism main for high school students in the field of Health.Analyzing the current situation of financial autonomy mechanism at the Quang Ninh Provincial Department of Health Protection and Care in the period of 2017 - 2021, thereby highlighting the difficulties and problems, and at the same time specifying the causes of the difficulties and problems at Proposing some solutions to improve the financial autonomy mechanism at the Quang Ninh Provincial Department of Health Care and Protection in the coming time In the scope of the research topic of the thesis and the ability At the level of the author, the thesis certainly cannot avoid certain shortcomings But it is hoped that the issues mentioned in the thesis can contribute a small part to improving the effectiveness of the implementation of the autonomy mechanism at the Quang Ninh Provincial Committee for Health Care and Protection in particular and perfecting the mechanism of self -control financial autonomy for high school students in general./ 20